As much as we all hoped we wouldn’t have to worry about this again, the COVID-19 pandemic persists as the spring tree pollen season begins. Pollen allergies affect millions of children and adults, causing misery for weeks to months each spring, summer, and autumn. The start of pollen season varies by location and weather, but trees release pollen in the spring, followed by grass and weeds each summer, then ragweed in the autumn. People allergic to mold spores can have symptoms throughout the year, especially during rainy weather.
There is some overlap in the symptoms caused by seasonal allergies and infection from COVID-19. This makes it challenging to determine when children need to stay home from school or adults from work. Unfortunately, the only way to know for sure is to be tested for COVID-19 and wait for the results before going back to school or work. However, there are some clues that may help distinguish the two.
Both COVID-19 and pollen allergies can cause nasal congestion, runny nose, cough, headache, and if someone also has asthma, then shortness of breath or difficulty breathing. However, unlike COVID-19, pollen allergies will not cause anyone to have a fever, severe fatigue, muscle aches, or stomach pain, vomiting, or diarrhea. A hallmark of pollen allergies is itching, which is not a common symptom with COVID-19. Pollen allergies can also cause conjunctivitis (often similar to pink eye), which makes eyelids red, itchy, and swollen and these symptoms are not associated with COVID-19 infection. Lastly, pollen season lasts for weeks to months, so allergy symptoms are often more persistent than those from COVID-19.
A complete loss of smell is reported in many people with COVID-19, but this is different than someone with allergies who is very congested and can’t smell quite as well. Each person can use their own history as a guide as well. Do you or your child have the same itchy, watery eyes, runny nose, and congestion every spring? If you have a history of pollen allergies, particularly if diagnosed by an allergist, then your typical symptoms occurring this year are expected. Unfortunately, anyone with allergies can also develop COVID-19 at any time, so this doesn’t remove the need for testing if new onset symptoms occur.
Each school, employer, and family will need to decide how to approach this overlap. Some may require test results and letters from physicians. As an allergist, I’ve written many letters outlining this same information but also emphasizing that the only way to be certain is by testing for COVID-19. Anyone who has a history of pollen allergies should make sure their treatment plan is current and that all medications have been started or are available. Pollen exposure inside the home can be reduced by keeping windows closed at all times, changing clothes after being outdoors, and bathing before bed each night. The best way to reduce school/work absence is to try and control allergy symptoms as much as possible. And the best way to try and prevent COVID-19 infection is to continue to wear face coverings, wash hands, and practice physical distancing.
For more posts about allergies and asthma by Dr. Stukus, click here.
David Stukus, MD, is an associate professor of pediatrics in the Section of Allergy and Immunology at Nationwide Children’s Hospital. Dr. Dave, as his patients call him, is passionate about increasing awareness for allergies and asthma.
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